[Measurement of success of treatment for chronic back pain. Can general effects in an entire sample of patients with chronic back pain be transferred to specific effects in individuals?].
BACKGROUND
The multimodal therapy has proved to be useful for the treatment of patients with chronic back pain. The aim of this methodical study was to test whether specific effects for the individual can be inferred from general effects of the entire sample, in order to define criteria for the success of treatment. These could be helpful when deciding to which patients the multimodal therapy can best be applied.


METHODS
A total of 408 patients with chronic back pain took part in a 3-week multimodal therapy program in a day hospital. The patients were questioned regarding parameters such as pain intensity, depression, functional back capacity and quality of life before therapy as well as 6 months after therapy.


RESULTS
On average, a significant improvement of all parameters could be shown after 6 months. However, scatterplots and correlations showed that general results of the entire sample should not be transferred to the individual patient


CONCLUSIONS
Taking into account principles of classical test theory this study showed that sufficient systematic coherence of the data must be proven before changes can be calculated. As long as neither an adequate systematic nor useful criteria can be found, there seems to be no reason to exclude any patient from multimodal therapy using pre-selection criteria.
Meier
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S
Orthopädische Universitätsklinik Heidelberg, Oberbettringer Str. 200, 73525 Schwäbisch-Gmünd, Deutschland. stefanie.meier@ph-gmuend.de
Neubauer
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E
Schiltenwolf
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M
D001416:Back Pain / Q000523:psychology / Q000628:therapy*; D003131:Combined Modality Therapy / Q000523:psychology; D003631:Day Care, Medical; D003863:Depression / Q000175:diagnosis / Q000523:psychology; D004185:Disability Evaluation; D005858:Germany; D006801:Humans; D019547:Neck Pain / Q000523:psychology / Q000628:therapy*; D010043:Outcome and Process Assessment, Health Care / Q000706:statistics & numerical data*; D010147:Pain Measurement / Q000706:statistics & numerical data*; D005791:Patient Care; D010348:Patient Care Team; D011379:Prognosis; D011446:Prospective Studies; D011594:Psychometrics; D011788:Quality of Life / Q000523:psychology; D016896:Treatment Outcome